Newborn And Baby/child Vaccinations

[patrickq]

As I understand it, newborn children in Thailand are given a vaccination soon after birth and this is compulsory. Can anyone tell me whether this is true. If so, can one refuse this and if so on what grounds.

Obviously, I wish to prevent this vaccination and so would appreciate comments only from those who have help to offer in this respect, rather than those querying why I choose not to vaccinate ... unless interested in considering the same for their child, rather than trying to convince me that I should vaccinate.

Hope that's all clear :-)

[Mid]

what's clear is your misunderstanding of the global village ............................

[patrickq]

what's clear is your misunderstanding of the global village ............................

? ... sorry, don't quite get what you're saying, can you explain ...

[Mid]

your personal choice , has an effect on others ,

and

is not your personal choice at all .......................................

[Prakanong]

As I understand it, newborn children in Thailand are given a vaccination soon after birth and this is compulsory. Can anyone tell me whether this is true. If so, can one refuse this and if so on what grounds.

Obviously, I wish to prevent this vaccination and so would appreciate comments only from those who have help to offer in this respect, rather than those querying why I choose not to vaccinate ... unless interested in considering the same for their child, rather than trying to convince me that I should vaccinate.

Hope that's all clear :-)

How soon after birth?

I will try to dig outv the Thai vaccination schedule - its on my PC somewhere. There is one issued by the MoH and then another reccomended by the Thai Paediatric Association.

Hmm - just went one better and asked a Dr who is a specialist with Paediatric vaccines - at birth in Thailand they give the BCG and Hep B vaccination - they even do this in Singapore.

Its due to the endemic nature of Hep B in Thailand.

[Khun Jean]

And the high occurance of tuberculosis BCG is also very important.

Hep B and tuberculosis are two nasty deseases which should make u reconsider vaccinations.

The risk is much much higher then in western countries.

[Prakanong]

And the high occurance of tuberculosis BCG is also very important.

Hep B and tuberculosis are two nasty deseases which should make u reconsider vaccinations.

The risk is much much higher then in western countries.

Exactly but its his choice.

All the Dr's I work with do not hesitate to have all their children vaccinated and they do know quite a bit about vaccines

[Prakanong]

The Thai Immuniation schedule for Children

So the HBV1 is followedup at month 2 or 3 with HBV2 then HBV3 at 6-12 months

DTP1/PV1/Hib1 and optionally RV1 (rotavirus) at month 2

The second of the above 2 months immunisations at 4 months and the 3rd at 6 month but without RV

JE and MMR at 9-12 months with JE having 2 at 2 weeks apart.

Flu at 6 months

Var at 12 months onwards and Hep A at 2.5 years onwards

If anyone needs more details I can probably get it if required.

[patrickq]

How soon after birth?

I will try to dig outv the Thai vaccination schedule - its on my PC somewhere. There is one issued by the MoH and then another reccomended by the Thai Paediatric Association.

Hmm - just went one better and asked a Dr who is a specialist with Paediatric vaccines - at birth in Thailand they give the BCG and Hep B vaccination - they even do this in Singapore.

Its due to the endemic nature of Hep B in Thailand.

Many thanks for this and the follow up schedule, I had read there was a vaccination given at birth as you mentioned, what I really want to find out is whether this can be legally refused in Thailand and if so how.

I appreciate the risks that others are concerned about, but after considerable investigation have reached the conclusion that vaccination is not the best way to tackle these risks.

[patrickq]

your personal choice , has an effect on others ,

and

is not your personal choice at all .......................................

still being obscure ... trying to understand what you're getting at ... agree that personal choice can have an effect on others, are you hinting that in this case my choice would have an effect on my child ... if so I have to agree again, hardly surprising ... choice for your child is involved quite a bit if you 'choose' to become a parent ... I still can't quite figure out what you mean by it not being my choice ... and where did the global village fit into all this ...

[Prakanong]

How soon after birth?

I will try to dig outv the Thai vaccination schedule - its on my PC somewhere. There is one issued by the MoH and then another reccomended by the Thai Paediatric Association.

Hmm - just went one better and asked a Dr who is a specialist with Paediatric vaccines - at birth in Thailand they give the BCG and Hep B vaccination - they even do this in Singapore.

Its due to the endemic nature of Hep B in Thailand.

Many thanks for this and the follow up schedule, I had read there was a vaccination given at birth as you mentioned, what I really want to find out is whether this can be legally refused in Thailand and if so how.

I appreciate the risks that others are concerned about, but after considerable investigation have reached the conclusion that vaccination is not the best way to tackle these risks.

I do not know about the legal situation - I know someone who will know exactly the position but she is out of her office travelling at the moment. Former practicing Thai Paediatrician with a very good reputation in Thailand and now a medical director in a vaccine company

As you say the choice is yours - I could argue all day about relative risk, I could put you in touch with very good clinicians who work in this area and even specialist paediatric vaccine specialists (One of which I was just talking to 10 minutes ago about Risk but to do with derivatives and option???) etc but its not for me to convince you.

I believe the disease burden is such that vaccination is the way to go and you believe the opposite and I doubt ever the twain will meet - can not say fairer than that.

[Bpraim1]

1000bht shot now or few 100,000 later for a hospital stay!

well you could just have the baby at home and then,you don't even need to worry about it.

Can't understand some people, If every country in the world arees that it is good, preventative measure to vaccinat, you may not need all that they offer, but your child needs most!

Just remeber you are in control of another life! One that can't help it's self yet! Why put it in more danger or pain.

[patrickq]

1000bht shot now or few 100,000 later for a hospital stay!

well you could just have the baby at home and then,you don't even need to worry about it.

Can't understand some people, If every country in the world arees that it is good, preventative measure to vaccinat, you may not need all that they offer, but your child needs most!

Just remeber you are in control of another life! One that can't help it's self yet! Why put it in more danger or pain.

Had you read the initial post I made when starting this thread you would have seen '... would appreciate comments only from those who have help to offer in this respect, rather than those querying why I choose not to vaccinate ...'

So, why not go and start a thread of your own so that you can espouse your beliefs there, I have spent many years looking at both sides of the argument, it is in fact one of the chapters covered in the book I am currently writing, so it is not just a spur of the moment inspiration. I believe the potential consequences of vaccination far outweigh any benefits. However, that is not the purpose of this thread, there are others on Thai Visa covering that.

Your last sentence is the very reason why I wouldn't vaccinate my child.

Thank you

[patrickq]

How soon after birth?

I will try to dig outv the Thai vaccination schedule - its on my PC somewhere. There is one issued by the MoH and then another reccomended by the Thai Paediatric Association.

Hmm - just went one better and asked a Dr who is a specialist with Paediatric vaccines - at birth in Thailand they give the BCG and Hep B vaccination - they even do this in Singapore.

Its due to the endemic nature of Hep B in Thailand.

Many thanks for this and the follow up schedule, I had read there was a vaccination given at birth as you mentioned, what I really want to find out is whether this can be legally refused in Thailand and if so how.

I appreciate the risks that others are concerned about, but after considerable investigation have reached the conclusion that vaccination is not the best way to tackle these risks.

I do not know about the legal situation - I know someone who will know exactly the position but she is out of her office travelling at the moment. Former practicing Thai Paediatrician with a very good reputation in Thailand and now a medical director in a vaccine company

As you say the choice is yours - I could argue all day about relative risk, I could put you in touch with very good clinicians who work in this area and even specialist paediatric vaccine specialists (One of which I was just talking to 10 minutes ago about Risk but to do with derivatives and option???) etc but its not for me to convince you.

I believe the disease burden is such that vaccination is the way to go and you believe the opposite and I doubt ever the twain will meet - can not say fairer than that.

We can agree to disagree on this, none of us knows the answers to everything, we just have to go with our beliefs and let others go with theirs

[g00dgirl]

patrickq, did you end up finding out more information about how to refuse vaccinations in Thailand, or did you get any personal experience with it in the meantime?

[Sheryl]

There are only 2 vaccines given at the time of birth:

- BCG (for TB)

- Hepatitis B

As far as I know, you can refuse both of these; patient have the right to refuse any and all treatment and in the case of a minor, the parents have that right. You will need to make those wishes known and keep watch tho because they tend to be part of standing orders in the hospital.

In the case of the Hep B, if you plan to refuse it, you should be sure that your wife is tested before or during pregnancy to make sure she is not a carrier. If she is a Hep B carrier and the baby is not immunized within 12 hours of birth there is a strong likelihood of neonatal hepatitis B and believe me, the risks of that outweigh whatever risks of immunization you are concerned about by a long shot. If however she is shown not to be a carrier then you can choose not to have the child immunized and let him or her decide this matter for themselves when old enough (just make sure they know that they never had the vaccine, and since the disease can be sexually transmitted, have that talk around the time of puberty).

The other vaccines are all administered later on during infancy. I don't recommend it, but you can choose not to bring your child to get them. What I am not sure of is whether proof of immunization is required at time of school registration here like it is in many countries, perhaps others can advise on that.

[patrickq]

patrickq, did you end up finding out more information about how to refuse vaccinations in Thailand, or did you get any personal experience with it in the meantime?

Still don't have definitive answers, but as Sheryl says I think they can be legally refused. As I understand it, the hospital may ask you to sign a form confirming your decision. We're hoping to have a homebirth, but this seems far more unusual in Thailand and it is very difficult to find a midwife, so we won't have to worry about an unrequested vaccination being given. However, if you're having a hospital birth I should be extremely careful, as I think there is a fair chance your wishes might be ignored, so you'll need someone else there to watch what goes on. I did read one comment saying that they would want to see vaccination certificate for child if you leave Thailand, which seemed very strange, so probably just an error, but still need to check this.

We visited Samitivej hospital to see facilities for having a natural/water birth and this inclined us even more to have a homebirth if possible ... seeing rows of newly borns lying in a room together, separated from their mum's, it was like some surreal scene from a futuristic sci-fi movie, where children are cloned and manufactured in a laboratory. At first, we thought these must be babies with problems, but 'no' they were all perfectly healthy and just being monitored, how far we have moved from having any understanding about what it is like to be born into this world, I find it tragic.

[geriatrickid]

You certainly have an individual right to decline. However, the community also has the right to place you in quarantine away from them as your offspring become disease reservoirs. Sounds harsh doesn't it, well that's what happens where children are not allowed into school if they do not have their immunizations. Don't expect your local Thai school to welcome your unvaccinated child or to make special exceptions on school vaccination days. Simply put, your claim of individual rights removes other people's rights to live in safety and you should be prepared to deal with the consequences.

[grtaylor]

To be honest, if you put a statement like this in:

Obviously, I wish to prevent this vaccination

you should expect to have it questioned. Its not obvious at all to me . . . .

[g00dgirl]

WHO - Immunization Profile - Thailand

A bit further down the page, you find the Immunization Schedule (2006 or latest available)

BCG (tuberculosis) birth;

DTwP 2, 4, 6 months; 1.5-2, 4-5 years;

DTwPHep 2, 4, 6 months;

HepB birth; 2, 6 months;

JapEnc 1.5-2 (x2), 2.5-3 years;

Measles 9-12 months;

MenACWY 2 weeks before visiting the affected areas;

MMR school children grade 1;

OPV 2, 4, 6 months;

Td school children grade VI; +1, +6 months; [ and Pregnancy Women 1st contact]

YF 2 weeks before visiting the affected areas; [travellers]

This confirms that at birth they give HepB and BCG (tuberculosis) vaccines.

HEPATITIS B VACCINE: THE UNTOLD STORY

hepatitis B is not common in childhood and is not highly contagious. Hepatitis B is primarily an adult disease transmitted through infected body fluids, most frequently infected blood, and is prevalent in high risk populations such as needle using drug addicts; sexually promiscuous heterosexual and homosexual adults; residents and staff of custodial institutions such as prisons; health care workers exposed to blood; persons who require repeated blood transfusions and babies born to infected mothers.

If the mother is tested and does not have Hepatitis B, I would prefer to re-evaluate the need for this vaccine later in life of the child.

BCG and your baby

BCG has been around so long that studies were actually done on it back in the 1968-71 by the World Health Organization. One study compared two sample populations in India of 375,000 people each. One group had the vaccine, and one did not. Findings were that this vaccine provided absolutely no protection. It would be 30+ years before Germany, Switzerland, and Austria removed this vaccination from their pharmacies. All vaccines are mandatory for public school attendance in the U.S. and always will be, no matter how ineffective or dangerous the vaccine is.

Facts about Bacille Calmette Guerin (BCG) Vaccine

Why was I given BCG?

In countries with high rates of TB, BCG is often given to infants at the time of birth because it helps prevent the more serious forms of TB disease from developing in children. In some countries BCG is given to the same person several times during childhood and early adult life, in an effort to maintain an immunity to TB. Repeated vaccination increases the likelihood of causing a positive skin test but may not increase protection against TB.

Does BCG work?

Unfortunately, the positive effect of BCG in protecting infants and young children from endemic areas from the lethal forms of TB does not extend to the adult years. Thus, many people develop active tuberculosis even though they received BCG, even in multiple doses, in earlier years. Since BCG has been used so widely and for such a long time, if it were effective it is unlikely that one third of the world's population would now have TB infection and that two million people a year worldwide would die of TB.

Recommendations (from CDC - Center of Disease Control)

Children. BCG vaccination should only be considered for children who have a negative tuberculin skin test and who are continually exposed, and cannot be separated from, adults who

Are untreated or ineffectively treated for TB disease (if the child cannot be given long-term treatment for infection); or

Have TB caused by strains resistant to isoniazid and rifampin.

[TerryLH]

"I did read one comment saying that they would want to see vaccination certificate for child if you leave Thailand..."

I've never heard that, but you might have to show proof of vacinations to enter some other countries.

I am curious about one thing.

In your original post you said, "and so would appreciate comments only from those who have help to offer in this respect, rather than those querying why I choose not to vaccinate...".

Did you seriously think that by saying that, that it would stop anyone from saying something anyway?

[Tammi]

"I did read one comment saying that they would want to see vaccination certificate for child if you leave Thailand..."

I've never heard that, but you might have to show proof of vacinations to enter some other countries.

I am curious about one thing.

In your original post you said, "and so would appreciate comments only from those who have help to offer in this respect, rather than those querying why I choose not to vaccinate...".

Did you seriously think that by saying that, that it would stop anyone from saying something anyway?

The only 2 things I was ever given were for polio and TB. I have travelled most of the world and for the past 20 odd years nobody has asked me about vaccinations .

Is there a link between childhood vaccinations and Autism? That is being explored with more interest at the moment. I heard an American lady with an autistic child say that recommended vaccination schedule for her child was to give it 36 injections. She was not happy!

Edited April 10, 2008 by Tammi

[Prakanong]

"Is there a link between childhood vaccinations and Autism? That is being explored with more interest at the moment"

Its pretty old hat now actually with some of the main protaginists fighting for their professional lives now due to their shoddy work trying to promote his.

There is no link - the notion has ben horoughly discredited and large scale Japanese and UK studies have shown this although the notion lives on in some peoples heads due to sensationalist press coverage that is not followed through with the outcomes of studies.

Even CNN's recent specials on autism had Dr's saying this as discredited now.

[Prakanong]

Hep B not highly contagious - it is VERY highly contagious and easily caight if exposed ie much more so than HIV fro example.

That sight realy ought to have peer review of its copy as its not really accurate.

[Sheryl]

The reason for giving Hep B vaccine to infants/children is:

(1) to protect against neonatal Hep Bm, which can occur if the mother is a carrier, which many women in SE Asia are (they may be completely asymptomatic).

(2) to provide life-long protection against a disease which is very dangerous and highly infectious albeit only through blood and sexual contact.

The first need is only if the mother is a carrier or her status unknown, so testing the mother is an option.

The second need, while it becimes more important at puberty, is not without application in infancy and childhood because infants and children can be injured or ill in such a way as to require blood transfusion.

There are good reasons for routine Hep B immunization of children in countries (like Thailand) with a high prevealnce of it. If the vaccine is not going to be given routinely then it is essential that the mother be tested to ensure she is not a carrier. If she is a carrier, immunizing the child within 12 hours of birth is unavouidably essential.

[g00dgirl]

A Dr.'s opinion (however in relation to babies in the USA) on youtube I found is interesting to watch:

(2) to provide life-long protection against a disease which is very dangerous and highly infectious albeit only through blood and sexual contact.

The second need, while it becimes more important at puberty, is not without application in infancy and childhood because infants and children can be injured or ill in such a way as to require blood transfusion.

The protection of the Hep B vaccine given at birth does not last into puberty, it is not life-long, only lasts a couple of years though.

So it would be a matter of evalutation the level of risk that the child, well before puberty, would require a blood transfusion or have sexual contact with a Hep B infected person. While the risk of coming in contact with blood of an infected person would be higher in Thailand where it is more prevalent, if someone has a baby in Thailand that will grow up overseas in a country with low prevalence and the mother did not test positive for Hep B, it really seems there is no good reason for this vaccine. For a child growing up in Thailand, one would have to evaluate the risk, this is my current conclusion.

[Prakanong]

"The protection of the Hep B vaccine given at birth does not last into puberty, it is not life-long, only lasts a couple of years though."

Let me check on that with a Childhood Vaccines specialist I know - I will not see him next week as I am a medical conference (Vaccines) although there will be plenty of people there for me to ask - Dr's who specialise in this including Thai as well as Study Managers from Hep B vaccines trials.

The reason I want to check as it used to be thought the adult vaccine lasted only around 10 years but we now beleive its for life - results prove much longer than 10 years - I am wondering is the childhood vaccine is the same.

As I said let me check - I work in clinical trials but am not a clinician - but I do talk to experts in their field most days.

[swiss kiwi]

your personal choice , has an effect on others ,

and

is not your personal choice at all .......................................

That may be your sincerely held opinion, but you have to realise that t is not shared by everyone, by any means.

In most countries, including Thailand, parents have freedom of choice concerning vaccination. It's up to them to research the vaccination issue in order to make an informed choice on behalf of their child. It's after all a basic human right to decide what goes into one's body, or the bodies of one's children.

Vaccines are not as safe and effective as the health authorities or the medical profession makes them out to be. Parents therefore need to investigate both sides of the issue, then do what feels righ to them. They have no obligations toward the medical profession, "society," or the state, in this regard, because it is ultimately the parents who will be affected by the possible consequences of their choice, of either vaccinating, or not vaccinating.

I recommend the website 'thinktwice' or 'Ian's Voice' to parents wanting to investigate the vaccinatio issue. I also highly recommend the book 'How to raise a healty child' by Dr. Robert Mendelsohn MD.

[swiss kiwi]

As I understand it, newborn children in Thailand are given a vaccination soon after birth and this is compulsory. Can anyone tell me whether this is true. If so, can one refuse this and if so on what grounds.

Obviously, I wish to prevent this vaccination and so would appreciate comments only from those who have help to offer in this respect, rather than those querying why I choose not to vaccinate ... unless interested in considering the same for their child, rather than trying to convince me that I should vaccinate.

Hope that's all clear :-)

This reply is probably a bit late, but I've posted my comment for the benefit of other thaivisa forum members who may be in a similar position as Patrick.

The first important point is that vaccination is not compulsory in Thailand. However, unlike in western countries, there isn't really anyone who questions the safety or the effectiveness of vaccines, so most, if not all Thai babies are jabbed at birth, and later with the other vaccines, in accordance with the Thai vaccination schedule.

I have two friends, one of them English, the other American, whose Thai wives have given birth in Bangkok hospitals. Both fathers decided against vaccinating their babies, so they looked around for a hospital where the staff was happy to accommodate their wish not to inject their babies with vaccines. My friend Alan's baby had to be put into an incubator for one day, so the staff hung a big sign on it in handwritten Thai: "No vaccines for this baby!" I suggest that parents who have decided against vaccination keep an eye on their baby,and hang a sign on the cot to that effect, just to make sure that their baby doesn't end up getting jabbed by a nurse who wasn't informed.

The BCG vaccine against TB has been discontinued in virtually every country, as it was found to be ineffective in preventing TB. I don't know why it is still given in Thailand; maybe the WHO forgot to inform the Thai health authorities. As regards the hep B vaccination at birth, unless their mother is Hep B positive, babies are not an at-risk group of getting hep B.

According to the FDA, there are no serious reactions to the hep B vaccine. This is incorrect. In a letter published in the New Zealand Medical Journal, Dr B Classen, who had been commissioned to investigate possible after-effects of the NZ government's hep B vaccination campaign a few years ago, stated that he found a 60% increase in juvenile insulin-dependent diabetes in New Zealand children, as a result of the hep B vaccination programme. In France, the

government was forced to discontinue its hep B vaccinaton programme for school children because of a high number of neurological disorders in children who were given this genetically engineered vaccine, and a large number of ensuing lawsuits by parents wishing to clam compensation for their vaccine-injured children. This vaccine occasionally causes fatal reactions (look up 'Ian's Voice' on the internet). I also have a friend who was vaccinated against hep B a few years ago, as part of her job as a nurse, and who has been unable to work since, due to the crippling chronic fatigue and rheumatoid arthritis she ended up with as a result of this vaccine. I have come across a number of cases such as hers.

It's parents' decision whether to vaccinate or not. I recommend they do some research in order to make an informed choice, after weighing up the pros and cons. I highly recommend the book 'How to raise a healthy child' by Dr Robert S Mendelsohn MD. This book deals with virtually any health problem parents may come across while bringing up a child; it also includes a very informative chapter on the vaccination issue. Parents (and travellers) may also find the website 'thinktwice', by the Global Vaccine institute helpful.

Edited May 31, 2009 by swiss kiwi

[Sheryl]

The above post is contains factually incorrect statements and would have been deleted had the Mods seen it more quickly.

Since however it has been posted for over 24 hours the following factual corrections are offered for those who may already have read it:

1. "According to the FDA, there are no serious reactions to the hep B vaccine. ".

I am not sure if this is meant to refer to the US FDA or the Thai FDA but not accurate in either case. All drugs and vaccines have side effects and these are clearly described, along with contraindications and precautions, in the literature, in the vaccine package inserts, etc. For concise information about the Hepatitis B vaccine, including both its potential benefits and risks, see this link:

http://www.fda.gov/downloads/BiologicsBloo...s/ucm110138.pdf

2. "In a letter published in the New Zealand Medical Journal, Dr B Classen, who had been commissioned to investigate possible after-effects of the NZ government's hep B vaccination campaign a few years ago, stated that he found a 60% increase in juvenile insulin-dependent diabetes in New Zealand children, as a result of the hep B vaccination programme"

This refers to findings in the 1990's which did not claim to establish cause and effect but rather simply noted that diabetes had increased in children (a trend worldwide) and hypothesized that it might be related to the introduction of the Hep B vaccine since the latter had come in at about the same time. In response, a large scale case-control study was done. The results, published in 2001, conclusively found there to be no link between the receipt of any of the vaccinations currently in use at that time (inc. Hep and the occurrence of juvenile diabetes, see http://pediatrics.aappublications.org/cgi/...full/108/6/e112

I am not aware of any further statements or publications by Dr. Classen on that topic since this research came out, but his descriptive report of 12 years ago, minus the details of the findings of the study it prompted, continue to be cited by various vaccine conspiracy theory groups.

3. "In France, the government was forced to discontinue its hep B vaccinaton programme for school children because of a high number of neurological disorders in children who were given this genetically engineered vaccine, and a large number of ensuing lawsuits by parents wishing to clam compensation for their vaccine-injured children."

Routine Hep B vaccination of schoolchildren was temporarily suspended in France in the mid 1990's after reports that several persons had developed multiple sclerosis a few weeks after they had received the vaccine. The possible relationship was thoroughly investigated and Hep B vaccination re-instituted after careful case-control studies showed no difference in the incidence of multiple sclerosis between children who had received the hep B vaccine and those who had not. Since then 7 large scale studies have been done, including one that followed over half a million people in Canada; these all failed to show any association between the vaccine and multiple sclerosis. Hep B is a routine part of the child immunization schedule in France .

3. "As regards the hep B vaccination at birth, unless their mother is Hep B positive, babies are not an at-risk group of getting hep B."

The vaccine is recommended even in cases where the mother is Hep B antigen negative. The reason for this is that children can indeed contact the disease through routes other than maternal-to-child transmission; the Hep B virus, unlike HIV, is able to live for some time outside the body and on objects (toothbrushes, clothes etc) and hence it can be contacted if a child’s mucous membranes or a cut/scraped area of skin comes into contact with anything that has previously been in contact with the bodily fluids of another (infected) person – even days afterwards. The risk is highest in households where somebody (not necessarily the mother) is a Hep B carrier and in day care settings or other situations where large numbers of very young children are together, but it can haoppen outside of those contexts as well. This type of transmission would be possible in older children and adults too, but is less likely since older kids and adults are less prone to cuts, scrapes etc, putting dirty objects into their mouths etc, and know to keep cuts and open skin away from potentially infected objects.

Hep B is far more serious in children and infection in childhood carries a much higher risk of chronic infection (a risk factor for cancer of the liver and cirrhosis) than infection in adults. About a third of all chronic carriers of Hep B in the West, and most carriers in SE Asia, acquired the infection in childhood. So even though the overall incidence of Hep B in young children is small, its greater severity means that the incidence of severe and/or chronic Hep B cases in that age group is disproportionately larger.

.

4. "The BCG vaccine against TB has been discontinued in virtually every country, as it was found to be ineffective in preventing TB. I don't know why it is still given in Thailand; maybe the WHO forgot to inform the Thai health authorities".

WHO still recommends the BCG vaccine in countries with as high burden of TB. BCG is not "ïneffective", it has been proven to reduce the incidence of TB meningitis and other forms of severe extrapulmonary TB in children under the age of 5. (Note that it is not expected to prevent TB altogether).